LONG-TERM CARE FACILITY ADVISORY BOARD Regular Meeting

January 8, 2014 at 1:30 in Room 1102 Oklahoma State Department of Health, 1000 N.E. 10th Street, Oklahoma City, OK 73117-1299

AGENDA

1. Call to Order…………………………………………………………..Dewey Sherbon, Vice-Chair

2. Roll Call………………………………………………………………..……………..Natalie Smith

3. Introductions………………………………………………………………………..….Kay Parsons Kay Parsons will begin introduction process for members of the board and Public Attendees.

4. Board History and Operational Routines………………………………………….…..Dorya Huser

Dorya Huser will discuss the history of the board and inform new members how the board operates.

5. Review and Action to Approve/Amend the January 09, 2013/ April 10, 2013/ July 10, 2013/ October 9, 2013 Regular Meeting minutes……………………….………………….. Kay Parsons

6. Nominating Committee for New Officers…………………………………………....Esther Houser

7. Bulk Medication Proposed Rule Acceptance………………………………………….Dorya Huser Dorya Huser will give an update on the Bulk Medication Proposed Rule acceptance by the board of health.

8. Statistical Report Update on Protective Service Operations…………………………..Dorya Huser

9. AL Assessment Form and Admission Standards……..……………………………..Mary Fleming Mary Fleming will discuss the Assisted Living assessment form and admission standards.

10. Psychotic Drug Usage Reduction Study……………………………………………..Mary Fleming Mary Fleming will give a status report to the board on the Psychotic Drug Usage Reduction study.

11. Update to the Implementation of the Fingerprint Based National Background Check………………………………………………….……………….……………Walter Jacques Walter Jacques will provide an update on the implementation of the Fingerprint Based National Background Check program.

12. QIS Update…………………………………………………………………………...…Mike Cook Mike Cook will provide the board with an update on the QIS process.

13. Challenges/ New Business….…………………………………...…………………….Dorya Huser

14. Public Comment

15. Adjournment

Oklahoma Statutes Citationized Title 63. Public Health and Safety Chapter 1 Public Health Code - Nursing Home Care Act Article Article 19 Section 1-1923 - Long-Term Care Facility Advisory Board Cite as: O.S. §, __ __

A. There is hereby re-created, to continue until July 1, 2010, in accordance with the provisions of the Oklahoma Sunset Law, a Long-Term Care Facility Advisory Board which shall be composed as follows:

1. The Governor shall appoint a twenty-seven-member Long-Term Care Facility Advisory Board which shall advise the State Commissioner of Health. The Advisory Board shall be comprised of the following persons:

a. one representative from the Office of the State Fire Marshal, designated by the State Fire Marshal,

b. one representative from the Oklahoma Health Care Authority, designated by the Administrator,

c. one representative from the Department of Mental Health and Substance Abuse Services, designated by the Commissioner of Mental Health and Substance Abuse Services,

d. one representative from the Department of Human Services, designated by the Director of Human Services,

e. one member who shall be a licensed general practitioner of the medical profession,

f. one member who shall be a general practitioner of the osteopathic profession,

g. one member who shall be a registered pharmacist,

h. one member who shall be a licensed registered nurse,

i. one member who shall be a licensed practical nurse,

j. three members who shall be of reputable and responsible character and sound physical and mental health and shall be operator-administrators of nursing homes which have current licenses issued pursuant to the Nursing Home Care Act and who shall have had five (5) years' experience in the nursing home profession as operator-administrators,

k. three members who shall be residential care home operator-administrators licensed pursuant to the provisions of the Residential Care Act,

l. three members who shall be adult day care facility owner-operators licensed pursuant to the provisions of the Adult Day Care Act,

http://www.oscn.net/applications/OCISWeb/index.asp?level=1&ftdb=STOKSThttp://www.oscn.net/applications/OCISWeb/index.asp?level=1&ftdb=STOKSThttp://www.oscn.net/applications/OCISWeb/index.asp?level=1&ftdb=STOKST63http://www.oscn.net/applications/OCISWeb/index.asp?level=1&ftdb=STOKST63%23Chapter1http://www.oscn.net/applications/OCISWeb/index.asp?level=1&ftdb=STOKST63%23PublicHealthCode-NursingHomeCareActhttp://www.oscn.net/applications/OCISWeb/index.asp?level=1&ftdb=STOKST63%23Article19

m. three members who shall be continuum of care facility or assisted living center owner-operators licensed pursuant to the provisions of the Continuum of Care and Assisted Living Act, and

n. six members who shall be over the age of sixty-five (65) who shall represent the general public;

2. The designated representative from the Office of the State Fire Marshal, the designated representative from the Department of Mental Health and Substance Abuse Services, the designated representative from the Department of Human Services, and the designated representative from the State Department of Health shall serve at the pleasure of their designators;

3. The initial appointments of the Governor shall be for the following terms:

a. the initial term of the member of the medical profession shall be for a three-year term,

b. the initial term of the member of the osteopathic profession shall be for a three-year term,

c. the initial term of the registered pharmacist shall be for a two-year term,

d. the initial term of the licensed registered nurse shall be for a two-year term,

e. the initial term of the licensed practical nurse shall be for a one-year term,

f. of the initial terms for the twelve members who are licensed operator-administrators for facilities pursuant to the Nursing Home Care Act, residential care homes pursuant to the Residential Care Act, adult day care facilities pursuant to the Adult Day Care Act, and continuum of care facilities and assisted living centers pursuant to the Continuum of Care and Assisted Living Act, four shall be for one-year terms, four shall be for two-year terms, and four shall be for three-year terms; provided that representatives for each of the terms shall include one individual representing facilities subject to the provisions of the Nursing Home Care Act, one individual representing residential care homes subject to the Residential Care Act, one individual representing facilities subject to the provisions of the Adult Day Care Act, and one individual representing continuum of care facilities and assisted living centers subject to the provisions of the Continuum of Care and Assisted Living Act, and

g. the initial terms for the six members of the general public over the age of sixty-five (65) shall be for one-, two-, three-, four-, five- and six-year terms respectively.

4. After the initial designations or appointments, the designated representative from the Office of the State Fire Marshal, the designated representative of the Oklahoma Health Care Authority, the designated representative of the Department of Human Services and the designated representative of the Department of Mental Health and Substance Abuse Services shall each serve at the pleasure of their designators. All other terms shall be for a three-year period. In case of a vacancy, the Governor shall appoint individuals to fill the remainder of the term.

B. The State Department of Health shall provide a clerical staff worker to perform designated duties of the Advisory Board. The Department shall also provide space for meetings of the Advisory Board.

C. The Advisory Board shall annually elect a chair, vice-chair and secretary-treasurer, shall meet at least quarterly, and may hold such special meetings as may be necessary. The members of the Advisory Board shall be reimbursed as provided for by the State Travel Reimbursement Act.

D. The Advisory Board shall have the power and duty to:

1. Serve as an advisory body to the Department for the development and improvement of services to and care and treatment of residents of facilities subject to the provisions of the Nursing Home Care Act, homes subject to the provisions of the Residential Care Act and facilities subject to the provisions of the Adult Day Care Act;

2. Review, make recommendations regarding, and approve in its advisory capacity the system of standards developed by the Department;

3. Evaluate and review the standards, practices, and procedures of the Department regarding the administration and enforcement of the provisions of the Nursing Home Care Act, the Residential Care Act and the Adult Day Care Act, and the quality of services and care and treatment provided to residents of facilities and residential care homes and participants in adult day care centers. The Board may make recommendations to the Department as necessary and appropriate;

4. Evaluate and review financial accountability standards, policies and practices of residential care facilities regarding residents' funds for which the facility is the payee, and evaluate and review expenditures made on behalf of the resident by the facility to ensure that such funds are managed appropriately and in the best interests of the resident; and

5. Publish and distribute an annual report of its activities and any recommendations for the improvement of services and care and treatment to residents of facilities and residential care homes and participants in adult day care centers on or before January 1 of each year to the Governor, the State Commissioner of Health, the State Board of Health, the Speaker of the House of Representatives, the President Pro Tempore of the Senate, and the chief administrative officer of each agency affected by the report.

Historical Data

Added by Laws 1980, c. 241, § 23, eff. October 1, 1980; Amended by Laws 1984, c. 128, § 5, eff. November 1, 1984; Amended by Laws 1986, c. 16, § 1, eff. July 1, 1986; Amended by Laws 1987, c. 98, § 27, emerg. eff. May 20, 1987; Amended by Laws 1989, c. 192, § 10, eff. November 1, 1989; Amended by Laws 1989, c. 345, § 3, eff. October 1, 1989; Amended by Laws 1990, c. 51, § 127, emerg. eff. April 9, 1990; Amended by Laws 1992, c. 109, § 1, emerg. eff. April 20, 1992; Amended by Laws 1995, c. 230, § 17, eff. July 1, 1995; Amended by Laws 1998, c. 42, § 1, eff. April 2, 1998 ( superseded document available); Amended by Laws 2001, SB 385, c. 17, § 1, emerg. eff. July 1, 2001 ( superseded document available ); Amended by Laws 2004, HB 2093, c. 25, § 1, eff. August 27, 2004 (superseded document available).

http://www.oscn.net/datafiles/superseded/oklahoma/statutes/title63/X020498X63%20OS%201-1923.htmlhttp://www.oscn.net/applications/oscn/DeliverDocument.asp?citeid=208492http://www.oscn.net/applications/oscn/DeliverDocument.asp?citeid=98605

DEPARTMENT OF HEALTH & HUMAN SERVICES

Centers for Medicare & Medicaid Services

Room 352-G

200 Independence Avenue, SW

Washington, DC 20201

CMS NEWS FOR IMMEDIATE RELEASE Contact: CMS Media Relations August 27, 2013 (202) 690-6145

New data show antipsychotic drug use is down in nursing homes nationwide

Nursing homes are using antipsychotics less and instead pursuing more patient-centered

treatment for dementia and other behavioral health care, according to new data released on

Nursing Home Compare in July by the Centers for Medicare & Medicaid Services (CMS).

Unnecessary antipsychotic drug use is a significant challenge in dementia care. CMS data show

that in 2010 more than 17 percent of nursing home patients had daily doses exceeding

recommended levels. In response to these trends, CMS launched the National Partnership to

Improve Dementia Care in 2012.

“This important partnership to improve dementia care in nursing homes is yielding results,” said

Dr. Patrick Conway, CMS chief medical officer and director of the Center for Clinical Standards

and Quality. “We will continue to work with clinicians, caregivers, and communities to improve

care and eliminate harm for people living with dementia.”

The Partnership’s goal is to reduce antipsychotic drug usage by 15 percent by the end of 2013.

These new data show that the Partnership’s work is making a difference:

The national prevalence of antipsychotic use in long stay nursing home residents has been reduced by 9.1 percent by the first quarter of 2013, compared to the last quarter of

2011.

There are approximately 30,000 fewer nursing home residents on these medications now than if the prevalence had remained at the pre-National Partnership level.

At least 11 states have hit or exceeded a 15 percent target and others are quickly approaching that goal. The states that have met or exceeded the target are: Alabama,

Delaware, Georgia, Kentucky, Maine, North Carolina, Oklahoma, Rhode Island, South

Carolina, Tennessee and Vermont.

The Partnership aims to reduce inappropriate use of antipsychotics in several ways – including

enhanced training for nursing home providers and state surveyors; increased transparency by

making antipsychotic use data available online at Nursing Home Compare; and highlighting

alternate strategies to improve dementia care.

Since its launch in early 2012, the goal of the Partnership has been to improve quality of care and

quality of life for the country’s 1.5 million nursing home residents. This broad-based coalition

includes long-term care providers, caregivers and advocates, medical and quality improvement

experts, government agencies, and consumers.

For more information on the Partnership’s efforts to reduce use of antipsychotic drugs in nursing

homes, please visit the Advancing Excellence in America’s Nursing Homes website:

http://www.nhqualitycampaign.org/star_index.aspx?controls=MedicationsExploreGoal.

# # #

http://www.medicare.gov/nursinghomecompare/search.htmlhttp://www.nhqualitycampaign.org/star_index.aspx?controls=MedicationsExploreGoal

OK National Background Check Program Effective Dates

12/30/2013

1

Effective Dates: all may start as of Feb. 1, 2014

Must Comply by March 1, 2014: Adult Day Care Centers Residential Care Homes

Must Comply by April 1, 2014: Specialized Nursing Facilities (ICF/IID and ICF/AD)

Must Comply by May 1, 2014: Applicants for employment with DHS and OSDH working inside LTCFs

Nursing Facilities 

Effective Dates: all may start as of Feb. 1, 2014Must Comply by June 1, 2014: Continuum of Care and Assisted Living facilities Hospice programs 

Must Comply by July 1, 2014: Medicare Certified Home Care Agencies

Must Comply by August 1, 2014: All other employers defined in Title 63 O.S. § 1‐1945(4)

Other Effective Dates For Nurse Aide Scholarship Programs operated under contract with the OHCA: may begin July 1, required by August 1, 2014.

Staffing agencies and independent contractors must match the compliance of the contracted employer.

Medicaid HCBS waivered providers as defined in Section 1915(c) or 1915(i) of the SSA may voluntarily participate in the submission of fingerprints for applicants. Instead: a name‐based check from the OSBIfee established in Section 150.9 of Title 74 (currently $15)determination of employment eligibility made by providers based on new barrier criteria

Training Events - Scheduled & TentativeDate Time Duration Organization Venue Town/City Capacity

Wednesday, January 15, 2014 10:00am 1 HourWes Watkins Career Tech

Wetumka 10

Tuesday, January 21, 2014 8:00am 4 HoursFrancis Tuttle Rockwell Camput

Oklahoma City 100

Thursday, January 23, 2014 9:00am 4 Hours

South Oklahoma Technical Center

Ardmore 60

Monday, February 03, 2014 TBD TBDNortheast Technology Center

Afton 100

Conference Participations PlannedDate Time Duration Organization Venue Town/City Capacity

March 11-12, 2014 TBD TBD Leading Age Oklahoma

Reed Conference Center

Midwest City

Tuesday, March 25, 2014 10:00am or 1 HourTulsa RC Conference TBD

Tulsa Unk.

May 5-7, 2014 9:00amOAHCP/OKALA

Embassy Stuites Norman

Norman Unk.

May 20-22, 2014 Inspired Living Conference

Embassy Stuites Norman

Oklahoma National Background Check Program 2014 Schedule of Trainings, Presentations and Attendance as of 1/6/2014

Nurse Aide Registry Statistics

Prepared for

Long Term Advisory Board

Wednesday, January 10, 2014

Vicki Kirtley, Director Nurse Aide Registry

For questions regarding:

Nurse Aide Registry, call (405) 271- 5124

Long Term Care Advisory Board Meeting Nurse Aide Registry Activity Report Second Quarter FY 2014 October 1, 2013 to December 31, 2013

New Advanced CMA Training Endorcements

Added Per

Quarter

CMA Respiratory

CMA Gastrostomy

CMA Glucose Monitor

CMA Insulin Administration

Total Certifications &

Registrations 1st 133 127 54 43 357

2nd 80 76 37 33 226

3rd

4th

Totals 213 203 91 76 583

CMA’s with Advance CMA training do not receive an additional Certification. The State regulation do not require that a notation of the advanced training be entered on the Nurse Aide Registry

New Feeding Assistants

Feeding Assistants are registered versus certified.

Added Per Quarter Feeders Assistants

1st 47

2nd 55 3rd

4th

Totals 102

Long Term Care Advisory Board Meeting Nurse Aide Registry Activity Report Second Quarter FY 2014 October 1, 2013 to December 31, 2013

Count of Certificates by Type

Types of Certifications

Unexpired Certifications

Certifications Eligible for Renewal

Total Certifications

ADC 26 171 197

LTC 40,026 77,721 117,752

CMA 5,560 14,473 20,039

CMA Gastro 2,259 1,578 3,837

CMA GM 797 370 1,169

CMA IA 572 290 864

CMA R 2,362 1,641 4,004

Feeding Assistant 558 1,160 1,718

HHA 15,445 35,187 50,633

DDCA 2,093 8,430 10,525

RCA 128 954 1,082

TOTAL 69,826 141,975 211,825

Substantiated Abuse - Long Term Care Aides

Added Per

Quarter Physical Sexual Verbal Mistreatment Neglect Misappropriation of Property Total

1st 0 0 0 0 2 7 9

2nd 1 3 3 7 3rd

4th TOTAL 1 0 0 0 5 10 9

Long Term Care Advisory Board Meeting Nurse Aide Registry Activity Report Second Quarter FY 2014 October 1, 2013 to December 31, 2013

Number of Approved Training Programs by Type

Long Term Care

Aides

Home Health Aides

Developmentally Disabled Direct

Care Aides Residential Care Aides

Adult Day Care Aides

Certified Medication

Aides Total

188 0 14 7 2 48 259

Home Health Aides are going through HHA Deeming Programs to become Certified.

Advanced CMA and CMA/CEU Training Programs

CMA Respiratory

CMA Respiratory/ Gastrostomy

CMA Glucose Monitor

CMA Insulin Administration CMA/CEU Total

1 26 2 18 35 82

Grand Total Number of Approved Nurse Aide Registry Programs - 341

Number of LTC Training Program Onsite Reviews Performed FY2014

1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total

19 41 60

Inspections are ongoing for 2014 Biennial LTC Nurse Aide Training Programs including all approved Nurse Aide Registry training programs (CMA, CMA Advanced, CMA/CEU, DDCA, RCA, ADC).

2014 Training and Presentations.pdfONBC 2014 Training and Pres

FY 2nd Qtr. NAR LTC Advisory Board Report 01062014.pdfNew Advanced CMA Training EndorcementsNew Feeding AssistantsTypesof Certifications